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Contact Information

STATE UNIVERSITY OF IOWA
105 E 9TH STREET
SUITE A
CORALVILLE, IA52241
 Phone: 319-467-2050
 Fax: 319-467-2070
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Clinic Pharmacy

3336C0002X 58 Medical Supply Company with Pharmacist
Indicates primary specialty

NPI Profile & details for STATE UNIVERSITY OF IOWA

NPI # 1811246473
LBN Legal business name STATE UNIVERSITY OF IOWA
Authorized official JOE MCKELVEY - (SR DIR OF GOVT REIMBURSEMENT)
Entity Organization
Organization subpart 1 No
Enumeration date 08/29/2012
Last updated 02/14/2025 - More than a year ago
Identifiers
IA License # 1419
IA Other 1107919 CONTROLLED SUBSTANCE REGISTRATION
IA Other 1419 STATE PHARMACY LICENSE
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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